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USRN Utilization Managment Nurses | Taguig | income 85K:Job description:Hiring Customer Service and BPO Jobs for Various Accounts DAY & NIGHT SHIFT / TELECOM, FINANCIAL, Information technology / HELPDESK, TECHNICAL SUPPORT, HEALTHCARE, SALES, EMAIL / CHAT SUPPORT, HOTEL/TRAVEL RESERVATION, BILINGUAL & BACK OFFICE POSITIONS Job Description . USRN with Active License » Performs Utilization Management (UM) reviews in conformity with U.S. State/Federal and other mandated regulations. » Maintains compliance with regulatory changes affecting UM. » Reviews UM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer or prescribed escalation protocol. » Releases UM determinations to claim stakeholders following client-established protocols. » Maintains all required UM review documentation in the UM software in a timely manner. » Serves as first level contact for customer concerns pertaining to UM reviews. Job Requirements . USRN - Utilization Management Nurses income P85,000 plus Signing Bonus Appropriate qualifications: » Holder of Active USRN License from any Mainland State » With 1 year utilization management practice gained from working in the BPO industry or any US healthcare company » Willing to work on night shift - rotational weekends off » Above average English proficiency » Must be residents of Greater Metro Manila area (provincial candidates outside of Metro Manila, Laguna, Cavite, Rizal and Bulacan will not be considered) Job Function . Customer Service / BPO / Call CenterHealthcare / Medical Minimum Education . College or Bachelor's Degree Graduate income . 55,000 and Above Benefits . Shift Allowance, Nightshift Differential, Performance Incentives, SSS/Philhealth/HDMF Benefits, HMO Locations . Metro Manila Employment Duration . Permanent (Full time) Total Years practice . 1 year practice in Call Center BPO . 1 year Skills:
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